BACKGROUND: The purpose of this study was to evaluate the effect of different doses of fentanyl and morphine on the spread of spinal analgesia produced by bupivacaine. METHODS: 40 patients undergoing arthroscopy or transurethral resection under spinal anesthesia were randomly assigned to receive intravenous 50 or 100 g of fentanyl(F-50, F-100) or 5, 10 mg of morphine(M-5, M-10). 10 min after, we assessed the new levels of analgesia and administered intravenous naloxone 0.4 mg. The levels of sensory analgesia was reassessed 10 min after naloxone. RESULTS: 10 minutes after intravenous opioids, the level of analgesia increased significantly in M-10 group compared with F-50, M-5 group. Naloxone antagonized the effect of opioids on spinal analgesia. CONCLUSIONS: We conclude that systemic opioids enhance the spread of analgesia in a dose dependent manner, and this enhancement was antagonized by naloxone.
Analgesia* ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Spinal ; Anesthetics ; Arthroscopy ; Bupivacaine ; Fentanyl* ; Humans ; Morphine* ; Naloxone

BACKGROUND: The analgesic efficacy and safety of transdermal fentanyl patch(TDFP) combined with intravenous ketorolac administration were evaluated. METHODS: TDFP releasing 75 mcg/h (Group 1) or 50 mcg/h (Group 2) or placebo (Group 3) were applied to 60 women at 2 hours before abdominal gynecologic surgery. Postoperatively, patients self-administered intravenous ketorolac as required using patient controlled analgesia. Each group was assessed following 48 hours with respect to vital signs, VAS pain score, satisfaction score, side effects, and cumulative ketorolac use. RESULTS: After operation, pain score and ketorolac demand were significantly lower and satisfaction score and side effects were significantly higher in TDFP group (Group 1, 2) than control group (Group 3). CONCLUSIONS: If TDFP is applied 2 hour before surgery, combined with a bolus dose of 200 mcg i.v. fentanyl at induction of anesthesia and ketorolac i.v. infusion in the postoperative period, it provides a significant degree of background analgesia without respiratory depression.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hysterectomy* ; Ketorolac* ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

This study was performed to investigate the effect of vitamin C and E supplementation on blood pressure, plasma lipids, folate, and homocysteine levels in smokers and non-smokersof college male students in Gyeonggi Area. The nutrient intakes were determined by a 24hr-recall method. The subjects were divided into six groups: vitamin C supplementation group (n: smokers = 10, nonsmokers = 10), vitamin E supplementation group (n: smokers = 10, nonsmokers = 10), vitamin C and E supplementation group (n: smokers = 10, nonsmokers = 10), respectively. There were no significant differences between the smokers and nonsmokers in terms of anthropometric measurements. Systolic and diastolic blood pressure were significantly higher (p < 0.05) in smokers than that of non-smokers. There was no significant difference in energy and other nutrients intakes between smokers and non-smokers. In plasma lipids levels, smokers had higher plasma triglyceride, LDL-cholesterol, VLDL-cholesterol, total cholesterol concentration than that of non-smokers (p < 0.05). HDL-cholesterol level of smokers had a tendency to be lower than that of nonsmokers. In smokers, AI, TPH, LPH were significantly higher than that of non-smokers (p < 0.01). Plasma folate, homocysteine levels were not significantly different between smokers and non-smokers. The effect of antioxidant vitamins supplementation in smokers: In vitamin C supplementation group, HDL-cholesterol level was significantly increased (p < 0.01) and AI, TPH, LPH were significantly decreased (p < 0.01). In vitamin E supplementation group, HDL-cholesterol level was significantly increased (p < 0.05). In vitamin C and E supplementation group, LPH was significantly decreased (p < 0.05). The effect of antioxidant vitamins supplementation in non-smokers: HDL-cholesterol level was significantly increased (p < 0.05) and AI, TPH, LPH were significantly decreased (p < 0.05) by vitamin C supplementation group. Plasma homocysteine level was decreased by vitamin E supplementation group in non-smokers p < 0.01). The results of this study showed that smoking had a tendency to increase plasma lipids levels that factor into the risk of coronary heart disease. It is considered that antioxidant vitamin supplementation in smokers had a tendency to decrease cardiovascular disease than in nonsmokers.
Ascorbic Acid ; Blood Pressure* ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Folic Acid* ; Gyeonggi-do* ; Homocysteine* ; Humans ; Male ; Plasma* ; Smoke ; Smoking ; Triglycerides ; Vitamin E ; Vitamins*

Purpose: This study was conducted to examine the results of designing and implementing a teaching program for medical education as the elective course for 4th-year students of medical course. Methods: In order to design the teaching program for medical education as an elective course, we conducted literature review, five medical education experts were interviewed, and the literature required in the design process was reviewed. A developing teaching program was implemented as an elective course in a medical school of Korea, and 4th-year students of medical course participated in the program. Results: In the elective course, the medical education program process competencies were derived into three categories: theoretical educational knowledge, teaching competency, and research competency for education. Moreover, instructional materials were developed to help students achieve these competencies. And project-based learning strategy was selected and implemented for 4th-year students in medical course, and positive satisfaction was confirmed. Conclusion As a study designed and implemented in a medical education program in a medical school in Korea, it is expected to be helpful when introducing medical education to undergraduate students or developing a medical education program to strengthen the teaching capacity of residents.

The currently available coronavirus disease 2019 (COVID-19) vaccines in South Korea include mRNA (Moderna® and Pfizer®) and adenoviral vector (AstraZeneca® and Janssen® ) vaccines. Dermatologic side effects of COVID-19 vaccines range from local injection site reactions to systemic eruptions, including morbilliform rashes or erythema multiforme. Pernio-like lesions, one of the most common cutaneous manifestations of COVID-19, have been rarely reported post-vaccination. Herein, we report four cases of pernio-like lesions, which were detected in a single tertiary hospital within 2 months, after the first dose of mRNA-1273 (Moderna® ) vaccination was administered. In this study, we discuss the clinical and pathological features of our cases and compare them with those of previously reported cases of pernio-like lesions after COVID-19 vaccination. It is pivotal to realize that perniolike lesions can be a possible side effect of COVID-19 vaccination and that the number of patients experiencing this side effect is bound to be quite high in real-world clinical settings.

OBJECTIVE: To find factors associated with dysmenorrhea, we surveyed the obstetric and gynecologic histories as well as socioeconomic factors of Vietnamese female residents in Can Tho (southern part of Vietnam) and Bavi (northern part of Vietnam) and Vietnamese female marriage immigrants living in South Korea. METHODS: From March 2010 to March 2011, 3,017 Vietnamese women aged 17 to 42 years (mean, 25.5 years) were recruited. Socioeconomic factors as well as baseline characteristics, including gynecologic history and menstrual patterns, were collected using questionnaires. The relationships between these factors and dysmenorrhea were analyzed using chi-square test, independent t-test and logistic regression analysis. RESULTS: Dysmenorrhea was found in 58.8% of all women. The mean age and the age at menarche were younger in the women with dysmenorrhea. A longer duration of menstrual flow and severe menstrual volume increased the risk of dysmenorrhea. The prevalence of dysmenorrhea was lower in women who had experienced pregnancy, term delivery and breastfeeding. The prevalence of dysmenorrhea in Vietnamese women was also different according to their educational status. When participants were divided according to their religious preferences, atheist women showed a lower prevalence with 55%, and women who were religious had a higher prevalence of dysmenorrhea. The body mass index, menstrual cycle length, monthly income, and duration of residency in Korea were not related with the prevalence of dysmenorrhea. CONCLUSION: Socioeconomic factors as well as age, menstrual pattern and obstetric history were related with dysmenorrhea in Vietnamese women.
Aged ; Asian Continental Ancestry Group ; Body Mass Index ; Breast Feeding ; Dysmenorrhea ; Educational Status ; Emigrants and Immigrants ; Female ; Humans ; Internship and Residency ; Korea ; Logistic Models ; Marriage ; Menarche ; Menstrual Cycle ; Pregnancy ; Prevalence ; Surveys and Questionnaires ; Republic of Korea ; Socioeconomic Factors

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean Version of the Conners Adult ADHD Rating Scales-42 items & 26 items (K-CAARS-42 & K-CAARS-26) in nonclinical adult subjects. METHODS: The K-CAARS-42 & K-CAARS-26 was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see validity, we performed the confirmatory factor analysis for determination of whether the four-factor model fit the data. RESULTS: The results showed that the subscales had acceptable internal consistency reliability and high test-retest reliability ; and the second-order scores showed significant correlation with the Korean version of the Barratt Impulsiveness Scale-11-Revised and Prospective and Retrospective Memory Questionnaire. The Confirmatory factor analysis revealed a four-factor structure of both K-CAARS-42 and K-CAARS-26. CONCLUSION: The K-CAARS-42 & K-CAARS-26 is reliable and has possible utility for symptom assessment of attention deficit and hyperactivity disorder in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of the K-CAARS-42 & K-CAARS-26 to clinical adult subjects.
Adult* ; Attention Deficit Disorder with Hyperactivity* ; Factor Analysis, Statistical ; Humans ; Memory ; Prospective Studies ; Surveys and Questionnaires ; Reproducibility of Results* ; Retrospective Studies ; Symptom Assessment

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean version of the Barratt Impulsiveness Scale-11-Revised (K-BIS-11-R) in Nonclinical Adult Subjects. METHODS: The K-BIS-11-R was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see external validity, we performed confirmatory factor analysis for determination of whether the three-factor model, proposed by the previous report, fit the data. RESULTS: According to the results, the K-BIS-11-R had an acceptable test-retest reliability and internal consistency reliability. In addition, the K-BIS-11-R total score and second-order subscale score showed significant correlation with Conners' Adult attention deficit/hyperactivity disorder Rating Scale-Korean and Buss & Durkee Hostility Inventory. In addition, no significant difference was observed between the K-BIS-11-R total score and demographic variables. Thus, the K-BIS-11-R total score was transformed to standard score. CONCLUSION: K-BIS-11-R is a reliable and valid measure and has possible utility for assessment of impulsiveness in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of K-BIS-11-R to clinical adult subjects.
Adult ; Factor Analysis, Statistical ; Hostility ; Humans ; Reproducibility of Results

No abstract available.
Autonomic Nervous System ; Hypohidrosis* ; Reflex, Abnormal*

BACKGROUND/AIMS: A self-report questionnaire is frequently used to measure symptoms reliably and to distinguish patients with functional gastrointestinal disorders (FGIDs) from those with other conditions. We produced and validated a cross-cultural adaptation of the Rome III questionnaire for diagnosis of FGIDs in Korea. METHODS: The Korean version of the Rome III (Rome III-K) questionnaire was developed through structural translational processes. Subsequently, reliability was measured by a test-retest procedure. Convergent validity was evaluated by comparing self-reported questionnaire data with the subsequent completion of the questionnaire by the physician based on an interview and with the clinical diagnosis. Concurrent validation using the validated Korean version of the Short Form-36 Health Survey (SF-36) was adopted to demonstrate discriminant validity. RESULTS: A total of 306 subjects were studied. Test-retest reliability was good, with a median Cronbach's alpha value of 0.83 (range, 0.71-0.97). The degree of agreement between patient-administered and physician-administered questionnaires to diagnose FGIDs was excellent; the kappa index was 0.949 for irritable bowel syndrome, 0.883 for functional dyspepsia and 0.927 for functional heartburn. The physician's clinical diagnosis of functional dyspepsia showed the most marked discrepancy with that based on the self-administered questionnaire. Almost all SF-36 domains were impaired in participants diagnosed with one of these FGIDs according to the Rome III-K. CONCLUSIONS: We developed the Rome III-K questionnaire though structural translational processes, and it revealed good test-retest reliability and satisfactory construct validity. These results suggest that this instrument will be useful for clinical and research assessments in the Korean population.
Dyspepsia ; Gastrointestinal Diseases* ; Health Surveys ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Surveys and Questionnaires*